@article {Strother919,
author = {Strother, C.M. and Bender, F. and Deuerling-Zheng, Y. and Royalty, K. and Pulfer, K.A. and Baumgart, J. and Zellerhoff, M. and Aagaard-Kienitz, B. and Niemann, D.B. and Lindstrom, M.L.},
title = {Parametric Color Coding of Digital Subtraction Angiography},
volume = {31},
number = {5},
pages = {919--924},
year = {2010},
doi = {10.3174/ajnr.A2020},
publisher = {American Journal of Neuroradiology},
abstract = {BACKGROUND AND PURPOSE: Color has been shown to facilitate both visual search and recognition tasks. It was our purpose to examine the impact of a color-coding algorithm on the interpretation of 2D-DSA acquisitions by experienced and inexperienced observers. MATERIALS AND METHODS: Twenty-six 2D-DSA acquisitions obtained as part of routine clinical care from subjects with a variety of cerebrovascular disease processes were selected from an internal data base so as to include a variety of disease states (aneurysms, AVMs, fistulas, stenosis, occlusions, dissections, and tumors). Three experienced and 3 less experienced observers were each shown the acquisitions on a prerelease version of a commercially available double-monitor workstation (XWP, Siemens Healthcare). Acquisitions were presented first as a subtracted image series and then as a single composite color-coded image of the entire acquisition. Observers were then asked a series of questions designed to assess the value of the color-coded images for the following purposes: 1) to enhance their ability to make a diagnosis, 2) to have confidence in their diagnosis, 3) to plan a treatment, and 4) to judge the effect of a treatment. The results were analyzed by using 1-sample Wilcoxon tests. RESULTS: Color-coded images enhanced the ease of evaluating treatment success in \>40\% of cases (P \< .0001). They also had a statistically significant impact on treatment planning, making planning easier in \>20\% of the cases (P = .0069). In \>20\% of the examples, color-coding made diagnosis and treatment planning easier for all readers (P \< .0001). Color-coding also increased the confidence of diagnosis compared with the use of DSA alone (P = .056). The impact of this was greater for the na{\"\i}ve readers than for the expert readers. CONCLUSIONS: At no additional cost in x-ray dose or contrast medium, color-coding of DSA enhanced the conspicuity of findings on DSA images. It was particularly useful in situations in which there was a complex flow pattern and in evaluation of pre- and posttreatment acquisitions. Its full potential remains to be defined. APanteroposteriorAVFarteriovenous fistulaAVMarteriovenous malformationDSAdigital subtraction angiographyHSVhue, saturation, valueImaskpixel intensity in the mask frameImaxmaximal enhancementIpeakpeak pixel intensityTTPtime to peak},
issn = {0195-6108},
URL = {http://www.ajnr.org/content/31/5/919},
eprint = {http://www.ajnr.org/content/31/5/919.full.pdf},
journal = {American Journal of Neuroradiology}
}